| NPI | 1750444725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35088790) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 4301091572) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.088790) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2023-10-10 |